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Organization
PEC REFERRAL SERVICE INC.
Active
Organization
PEC REFERRAL SERVICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN HERMAN (OWNER)
(662) 334-6335
Entity
Organization
Contact information
Practice address
2353 SOUTH RIDGE CENTER, BOX 121, GREENVILLE, MS 38702-0121
(662) 334-6335
Mailing address
2353 SOUTH RIDGE CENTER, BOX 121, GREENVILLE, MS 38702-0121
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
60609
MS
385HR2055X
Child Mental Illness Respite Care
60609
MS
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
60609
MS
385HR2065X
Child Physical Disabilities Respite Care
60609
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770569
—
MS
Enumeration date
08/19/2008
Last updated
02/19/2009
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